For employers and workers alike, the issue of how to get injured employees back on the job-quickly-is one that has emotional and financial ramifications.

After a trip to the doctor, the next stop is often the Ohio Bureau of Workers' Compensation (BWC). "Our goal is to devise a plan that gets an injured worker back to work as soon as he or she is released by their physician. We want employers to accommodate them with productive work as they move toward recovery," says Tina Elliott, a physical therapist and manager of BWC's transitional work grant unit.

Companies often ease injured employees back to work using light duty. These transitional assignments take into account the worker's medical restrictions. Injured workers receive BWC benefits to replace or supplement lost income. Employers get incentives to offset their BWC premiums.

"The idea is to change the company's attitude toward workers' compensation. BWC incents companies to be aware of why their premiums are what they are and help them get control over their injured worker claims. Transitional work is a long-term solution for that," Elliott says.

Employers pay BWC premiums based on their payroll, injuries and cost per claim. "The big incentive is to lower claim costs. You do that by getting people back to work, because the longer a worker is at home not working, the greater the chances he'll never return," says attorney Steve Loewengart, office managing partner at Fisher & Phillips.

Workers' comp law does not require employers to return injured workers to the job, as long as not doing so isn't punitive or retaliatory. But if a workplace is amenable to light duty, it can reduce overall BWC premium costs. As a bonus, injured workers benefit from regaining wages and feeling productive again. "It can be a real win-win," Loewengart says.

Medical Treatment

There are several main players in the workers' comp arena. BWC makes decisions on claim allowances and issues benefit payments. Managed care organizations (MCOs) are private companies that medically manage workers' compensation claims for enrolled employers.

"BWC contracts with us. Every two years, businesses enroll with an MCO," says Richard Poach, president and CEO of CareWorks, one of 17 MCOs serving Ohio.

Injured workers choose their own BWC-certified health-care provider, who documents and reports on the employee's progress.

"CareWorks works with the doctor, injured worker and employer to coordinate an appropriate and effective treatment plan," Poach says. "The ultimate goal is a timely and safe return to work for the employee."

In the meantime, BWC initially pays injured employees temporary total (TT) compensation to make up for lost wages. TT is paid when the worker can't return to his former position or hasn't reached maximum medical improvement.

"For the first 12 weeks, the employee receives 72 percent of the full weekly wage he was making at the time of the accident. After that, TT is 66 2/3 percent of his average wage for the year prior to the accident," says attorney Phil Fulton of the Philip J. Fulton Law Office. He represents injured workers and is the author of Ohio Workers' Compensation Law. It's considered the authoritative source on the subject for legal professionals and others.

TT is paid indefinitely, which leads some employers to contest the findings of the treating physician. "Companies can ask for an independent medical exam. It could show that the employee is no longer entitled to TT, that he's reached a medical plateau and isn't expected to make further recovery," Loewengart says.

When a difference of opinion occurs between medical professionals, the employer can file for a hearing before the Ohio Industrial Commission to resolve the dispute.

Light Duty

As medical treatment progresses, an employee may be released to work with restrictions. Transitional work assignments must be put in writing. "It needs to include a good job description and be within the medical restrictions. It also must be within the employee's job skill capabilities, unless the employer and employee agree to changes in the worker's career path," Loewengart says.

Nicole Smith, president of the Human Resources Association of Central Ohio and regional development manager for Trustaff, says her recruiting and staffing firm encounters light duty from time to time.

"We're limited by what our employer clients can provide the employees," Smith says. "We find they're most successful when there's ongoing communication about the injury and restrictions. We see a lot of restrictions on lifting and standing, so then we try to place them in an office setting."

BWC statistics show its return to work rate has hovered around 70 percent since January 2012, the year the agency introduced its bonus transition work program. "If the company uses its formal plan to bring an injured worker back to work, we recalculate their premium costs. The employer can receive up to a 10 percent discount in their pure premium," Elliott says.

Putting injured employees back to work offers broader savings, too. "If the employer can keep the injured worker's claim as a medical claim only and get them back to work sooner, that positively impacts their claims experience," Elliott says. "Once it turns into a lost time claim, BWC starts paying the employee some sort of compensation and that increases the employer's premium costs."

Some employees are reluctant to accept a light-duty assignment. Fulton says injured workers may fear re-injury, inability to do the new work or failing to make up financially what they've lost because of the injury. He's well aware of the stereotype that they don't want to return to work.

"Last time I looked, disabled people are not rich people. The philosophy behind workers' comp is not to make the employee whole, but rather to provide a prompt process to receive benefits, but not full economic recovery," Fulton says. "Workers' comp keeps them from drowning financially, but it's much better for them to get back to work."

Beyond the financial aspects, Poach says, there are other benefits: "Accepting light duty can slow physical deconditioning and loss of work skills, as well as boost the worker's morale."

If an injured employee rejects a good faith transitional job offer, his TT payments end. The incentive to accept is BWC's wage loss benefit. It pays 66 percent of the difference between the worker's regular pay and the lesser light-duty pay. It has a 200-week limit.

Consistent Policies

HR and workers' comp professionals say it's advantageous for businesses to have a return to work policy.

"A good return to work policy has clear language and is applied consistently. It doesn't result in the employee having a light-duty job forever, but moves him through a formal process to return to regular duty. It also outlines the process if the worker ultimately cannot return to regular duty," Loewengart says.

Recent headlines surrounding the Columbus Division of Fire demonstrate the importance of policy language. An investigation by The Columbus Dispatch revealed that for more than a year, a dozen-plus injured firefighters working desk jobs earned full pay, despite the city's policy that generally limits light duty to 90 days. The fire chief and union president are in agreement that adding a specific end date would be beneficial. Columbus Mayor Michael Coleman directed the Department of Public Safety to devise a resolution; a policy was being drafted as of mid-April.

Companies without a formal return to work plan can apply for a BWC grant to hire an accredited transitional work developer to design a customized program. The tiered grants, ranging from $2,900 to $6,300, are based on the recipient's number of employees.

"The 3-to-1 matching grants reimburse employers 75 percent of cost of putting their program together," Elliott says. "Up to 25 percent of unused grant money can be used later for implementation, training or making plan improvements."